MEWS评分和SIRS评分评估急诊抢救室患者早期预后的对比研究  

Clinical study between MEWS score and SIRS score for the evaluation of the early outcomes of patients in emergency room

作　　者：孙宝迪[1] 邵旦兵[1] 刘红梅[1] 张炜[1] 任艺[1] 王康[1] 钱键[1] 唐文杰[1] 许宝华[1] 吴学豪[1] 聂时南[1] 

机构地区：[1]解放军南京军区总医院急救医学科,江苏南京210002

出　　处：《中国急救医学》2012年第1期54-57,共4页Chinese Journal of Critical Care Medicine

基　　金：南京军区122工程重点培养对象资助项目（No.JQZD200905）;南京军区南京总医院青年基金课题（No.2011029）

摘　　要：目的比较MEWS评分和SIRS评分对急诊抢救室患者早期预后评估效果的临床研究。方法对我院急诊抢救室救治的372例患者于入院24h内分别进行MEWS评分及SIRS评分，分析不同评分患者在急诊抢救室的早期病死率，评价MEWS评分及SIRS评分与抢救室患者早期预后的相关性，并对比两种评分方法分辨力及鉴别能力。结果随着MEWS评分及SIRS评分分值的增高，患者早期在各个分值范围的死亡构成比均升高，MEWS评分及SIRS评分ROC曲线下面积分别为0．883和0．762，均对患者早期预后具有中等范围分辨力，且两曲线下面积比较显示MEWS评分较SIRS评分具有较高的敏感性和特异性（P〈0．01），MEWS评分的Youden指数为5．5分。结论MEWS评分比SIRS评分可更好地判断急诊抢救室患者早期预后，且MEWS评分大于等于6分时可认为患者具有较高的早期死亡风险。Objective To compare the effects of MEWS score and SIRS score in emergency room patients for assessing clinical early prognosis. Methods 372 patients from our hospital emergency room were evaluated with MEWS score and SIRS score within 24 hours after admission to our hospital. Early mortality was analyzed in emergency room patients with different scores. Relationship of MEWS score and SIRS score with early prognosis of patients in emergency room and the two scoring resolution and identification capabilities were evaluated and compared. Results The MEWS score and SIRS score increased, the mortality were higher at the early range of scores at the same time, area under ROC curve of MEWS score and SIRS score were O. 883 and 0. 762. The differences in area under the ROC curve showed MEWS score was more sensitive and specific than the SIRS score（ P 〈 0.01 ）. The Youden index of MEWS score was 5.5 points. Conclusion MEWS score is better than the SIRS score in evaluating early prognosis of patients in emergency department, and the patients have high risk of early death when the MEWS score is more than 6.

关 键 词：改良早期预警评分 全身炎症反应综合征评分 急诊抢救室 早期预后 

分 类 号：R542.2[医药卫生—心血管疾病]